Net Savings for Higher-Quality Colonoscopy

(HealthDay News) — Higher-quality colonoscopies are associated with a 50–60% lower risk for colorectal cancer and colorectal cancer fatalities over a patient's lifetime, according to research published in the June 16 issue of the Journal of the American Medical Association. The researchers also note that higher-quality screenings did not translate into more expensive screenings.

To assess how the detection rate of a colonoscopy may affect a patient's future cancer risk, the study team looked at data for 57,588 patients who were part of the Kaiser Permanente Northern California health care system. Those patients who underwent colorectal cancer screening had their colonoscopies performed by 136 different doctors between 1998–2010. For this study, physicians were rated based on the number of adenomas detected.

The analysis indicated that undergoing a colonoscopy, regardless of quality, does save lives. For example, the lifetime colorectal cancer risk among those who didn't get screened was 34.2 per 1,000. This compared with 26.6 per 1,000 among those screened by doctors with the lowest adenoma detection rates and 12.5 per 1,000 for those screened by doctors with the highest rates of adenoma detection. The researchers reported that estimated net screening costs were lower from quintile 1 to quintile 5 of adenoma detection rates due to averted cancer treatment costs.

"The results further suggest that efforts to improve the detection and removal of precancerous polyps will likely not only help patients, but will support current efforts to improve the quality of the test and be cost-effective," lead author Reinier Meester, of the Erasmus MC University Medical Center in Rotterdam, Netherlands, told HealthDay.